Objective To investigate the basic perceptions, attitudes and needs towards delirium among ICU professionals in Shandong province, so that to help the ICU supervisors design target training for ICU professionals. Methods A survey was employed utilizing a self-designed questionnaire among 917 ICU professionals(doctors and nurses) from 62 hospitals in Shandong province. Results The score of ICU professionals′ basic perception and behavioral attitude concerning ICU delirium were (24.56 ± 6.36) and (19.00 ± 3.01) points respectively. The score had significant positive correlation and indicates statistic significance (r=0.53, P<0.01). Academic, work experience and title had influence on the score of basic perception (F=14.49, 26.25, 40.16, P<0.05), work experience, category of ICU, title and category of hospital were the effect on the score of behavior and attitude (F=11.87, 8.64, 6.55, P<0.05;t=4.81, P<0.05). The lower rate of correct responding to knowledge of ICU delirium were as follows:the correct rate of delirium in ICU of typing to 56.92%(522/917); the clinical manifestations of ICU delirium accuracy 65.32%(599/917); andrisk factors for delirium in ICU of the correct rate for 70.34%(645/917).ICU professionals acquire knowledge pertaining delirium mainly through lectures, conferences, knowledge brochure , exchange of experience. Conclusions The ICU professionals in Shandong province have less knowledge on ICU delirjum.ICU management should recognize the importance of ICU delirium to strengthen the training of relevant knowledge, enhance delirium management, ensure the patient's safety and improve the prognosis of patients.

ROS-mediated oxidative stress involved in a variety of cellular signal transduction, FOXO3a transcription factor is an intersection in regulating a variety of cellular oxidative stress. FoxO3a has been extensively studied in regulating oxidative stress because of its rather complex and pivotal regulation of cell proliferation, cell cycle arrest, ROS scavenging and apoptosis. This review will elucidate the FOXO3a’s regulatory mechanisms and describe the target genes involved. It will also provide the clinical significance and strategies to target FOXO3a to regulate oxidative stress.

Respiratory mucosal immune system is the body''s first line of defense against infection.Since the outbreak of novel coronavirus disease 2019 (COVID-19) in 2019,nasal mucosal immune vaccine, with its ability to induce cellular, humoral and mucosal triple immune responses, has become a research hotspot.This article focuses on novel coronavirus, with an understanding of its structure and pathogenesis, a brief introduction to the immune mechanism of nasal mucosa, a summary of the different types of nasal mucosal immune vaccines and their clinical research, aiming to provide some theoretical reference for the development of new vaccines, and exploration of the best methods and strategies to combat COVID-19.

Objective:To observe the correlation between the frontal P-wave axis and the severity of chronic obstructive pulmonary disease (COPD) and the prognosis evaluation system.Methods:Patients with COPD>45 years old who were followed up in the outpatient department of Hunan Chest Hospital from January to July 2022 were continuously selected as subjects. At the same time, the healthy people who examined in the health management center of our hospital were in the control group. Both groups of subjects completed electrocardiogram and pulmonary function tests. The level of frontal P-wave axis and the results of pulmonary function examination were recorded, and the differences of frontal P-wave axis between the COPD group and the control group were compared, so as to clarify the value of frontal P-wave axis in the diagnosis, disease severity and prognosis evaluation of COPD.Results:The level of forced expiratory volume in the first second/forced vital capacity(FEV1/FVC )in the COPD group was significantly lower than that in the control group, while the level of P-wave axis was significantly higher than that in the control group (all P<0.05). The receiver operating characteristic (ROC) curve of P-wave axis showed that the AUC of P-wave axis in predicting COPD was 0.96 ( P<0.001), the best cut-off value was 63.80, the sensitivity was 0.89, and the specificity was 0.93. There were significant difference in P-wave axis level, the forced expiratory volume in one second to forced vital capacity ratio (FEV 1%pred), body mass index (BMI) and BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index between groups according to the degree of airflow limitation (all P<0.05). Correlation analysis showed that P-wave axis level was positively correlated with BODE index ( r=0.77, P<0.001), and negatively correlated with pulmonary function FEV 1%pred ( r=-0.76, P<0.001). Conclusions:There is a good correlation between the level of frontal P-wave axis and the severity of COPD and the prognosis evaluation system, which has clinical application value.

Pregnane X receptor (PXR, NR1I2) is a prototypical member of the nuclear receptor superfamily. PXR can be activated by both endobiotics and xenobiotics. As a key xenobiotic receptor, the cellular function of PXR is mostly exerted by its binding to the regulatory gene sequences in a ligand-dependent manner. Classical downstream target genes of PXR participate in xenobiotic responses, such as detoxification, metabolism and inflammation. Emerging evidence also implicates PXR signaling in the processes of apoptosis, cell cycle arrest, proliferation, angiogenesis and oxidative stress, which are closely related to cancer. Here, we discussed, in addition to the characterization of PXR , the biological function and regulatory mechanism of PXR signaling in cancer, and its potential for the targeted prevention and therapeutics.

Objective:To observe and compare the changes of pulmonary function in patients with pulmonary tuberculosis regular treatment for 3 months.Methods:From April 2018 to June 2019, 500 tuberculosis patients who received regular anti tuberculosis treatment in our hospital were selected.The pulmonary function of patients with pulmonary tuberculosis was measured before treatment and at the end of three months; the results of pulmonary ventilation function, lung volume, diffusing capacity, and the value of forced vital capacity (FVC), maximum expiratory volume in 1 second (FEV 1), maximum expiratory volume in 1 second/forced vital capacity (FEV 1/FVC), total lung volume (TLC), residual volume (RV), carbon monoxide diffusing capacity (D LCO) were compared. Results:252 patients with pulmonary tuberculosis were included. Before treatment and at the end of three months, the abnormal pulmonary function results were 204 cases (80.95%) and 193 cases (76.59%), respectively, and the difference was not statistically significant ( P>0.05). Among them, abnormal pulmonary ventilation function is the most common, especially with obstructive, followed by abnormal diffusing capacity. At the end of three months, the proportions of patients with normal pulmonary ventilation function and normal lung volume were higher than that before treatment ( P<0.05), but there was no significant difference in the proportion of normal diffusing capacity before and after treatment ( P>0.05). The values of FVC, FEV 1, TLC and D LCO at the end of three months were higher than those before treatment, and the difference was statistically significant ( t=-6.414, -6.754, -3.863, -3.311, all P<0.01). Conclusions:Most patients with pulmonary tuberculosis have abnormal pulmonary function. At the end of the three months treatment, the normal rates of the pulmonary ventilation function and lung volume as well as the values of FVC, FEV 1, TLC and D LCO in patients with pulmonary tuberculosis were significantly improved compared with those before treatment.

Background and objective Standard operation procedure (SOP) could standardize treatment procedure and reduce medical expenses,but SOP drawn by the government may not suit all medical institutions,so individual adjustment made by surgical team is necessary.Methods We recorded the information of patients undergoing lung resection,including postoperative hospital stay,medical expenses and ratio of video-assisted thoracoscopic surgery (VATS) rate to evaluate surgical quality sustaining improvement in terms of structure indicator,process indicator and outcome indicator,aiming at exploring the ideal postoperative hospital stay and the best indicators to evaluate surgical quality improvement.Results The average postoperative hospital stay reduced significantly between 2016 and 2013 [(4.08±1.8) d vs (6.13±3.6) d,P＜0.001)].VATS rate increased from 2013-2016 (17％→48％→68％→73％),as well as single port VATS rate (0％→2％→52％→66％).Conclusion Surgical quality surveillance and sustaining improvement by surgical team could further reduce postoperative hospital stay and perioperative complications.

Background and objective Lung cancer is the leading form of cancer in terms of both incidence and cancer-related deaths. For patients with resectable Ⅲa/N2 non-small cell lung cancer (NSCLC), guidelines in and abroad recommend multidisciplinary team treatment, including surgery and chemotherapy, radiotherapy or other comprehensive treatment. Newly published evidences prove that neoadjuvant therapy can improve outcomes of NSCLC patients significantly, with advangtages in tolerability and compliance medication. Neoadjuvant therapy has been adopted mainly in locally advanced NSCLC, especially in stages Ⅲa/N2 patients, and chemotherapy of 2-4 cycles has become the basic pattern. Neoadjuvant therapy does not increase the concomitant complications of chemotherapy and surgery. However, challenges still exist in deter-mining subsequent surgical timing, approach and extent of resection.

Objective     To observe and describe anatomical types of the pulmonary arteries to keep safety of lung resection. Methods     Between November 25, 2005 and January 22, 2013, 194 patients who underwent right upper lobectomy/sleeve lobectomy or combined lung resection including right upper lobectomy were included in Peking University Cancer Hospital. There were 128 males with a median age of 59 (37-86) years and 66 females with a median age of 60 (42-77) years. We separated the pulmonary arteries and recorded the number and positions of them. Some patients were recorded photographically. Results     There were 10 types of right upper lobe pulmonary artery branches in this study. Type 1: 1 apicoanterior segmental artery, 1 ascending segmental artery, 96 patients (49.5%); Type 2: 1 apicoanterior segmental artery, 2 ascending segmental arteries, 48 patients (24.7%); Type 3: 2 apicoanterior segmental arteries, 1 ascending segmental artery, 28 patients (14.4%); Type 4: 2 apicoanterior segmental arteries, 2 ascending segmental arteries, 9 patients (4.6%); Type 5: 1 apicoanterior segmental artery only, 6 patients (3.1%); Type 6: 1 apicoanterior segmental artery, 3 ascending segmental arteries, 3 patients (1.5%); Type 7: 4 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 8: 3 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 9: 2 apicoanterior segmental arteries, 1 patient (0.5%); Type 10: 3 apicoanterior segmental arteries, 2 ascending segmental arteries, 1 patient (0.5%). Conclusion     The types of pulmonary artery branches are predictable in some way. It would be helpful to reduce the risk of pulmonary artery injury and improve the operation safety by following   the rules. Variations of pulmonary artery should be noticed to avoid the major bleeding due to the pulmonary artery injury.

Humans ; Pulmonary Disease, Chronic Obstructive ; Smoke/adverse effects* ; Tobacco ; Tobacco Smoke Pollution